M.Zeki Bayraktar

Safety and Effectiveness of Interferon Alpha-2a in Treatment of Patients with Behçet's Uveitis Refractory to Conventional Treatments

PURPOSE To evaluate the intermediate-term safety and effectiveness of interferon alpha-2a (IFNalpha2a) in patients with Behçets uveitis (BU) refractory to corticosteroids and immunosuppressive agents. DESIGN Open, nonrandomized, uncontrolled, interventional, prospective study. PARTICIPANTS Fifty-three patients (106 eyes) with active, vision-threatening BU who failed to respond to conventional treatments. INTERVENTION In 53 patients, acute inflammation was suppressed with effective prednisolone dosage (1-2 mg/kg/day, tapered to 10 mg within 4-6 weeks). The patients were treated with IFNalpha2a 4.5 million international units (MIU) 3 times per week for the first 3 months followed by IFNalpha2a 3 MIU 3 times per week for the next 3 months. Observation or other treatment methods were performed according to the decision tree developed for this study. MAIN OUTCOME MEASURES Remission and complete response (primary outcome measures), frequency of uveitis attacks, visual acuity (VA), and adverse effects (secondary outcome measures). RESULTS During 2 years of follow-up (median 65 months, range 12-130 months), compliance with the therapy was excellent. At the end of 1-year follow-up, treatment response was obtained in 45 of 53 patients (84.9%). The mean attack rate of 3.6+/-1.1 per year (range, 2-8) decreased to 0.56+/-0.75 (range, 0-4) per year (P=0.001). Visual acuity improved (> or = 0.2 logarithm of the minimum angle of resolution units from initial VA) in 30 eyes (28.3%) and worsened in 12 eyes (11.3%). Five patients (9.4%) did not respond to the initial treatment, and 3 patients (5.6%) developed severe adverse effects, including psoriasis, epileptic seizure, and extreme tiredness. Fifteen patients (28.3%) were off treatment for all the medications and disease free for 28+/-13.1 months (range, 12-50 months). CONCLUSIONS These results suggest that IFNalpha2a may be a valuable treatment option in BU that is refractory to corticosteroids and conventional immunosuppressive agents. The possible role of IFNalpha2a as a first-line agent in BU should be validated in randomized controlled clinical trials against newly described biologic agents. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Assessment of optic nerve head topographic parameters with a confocal scanning laser ophthalmoscope

Aim: To assess the disc area, age, sex, laterality (side of the eyes) and refractive error dependent differences in optic nerve head topographic parameters in a normal population.

Ingestion of IH636 grape seed proanthocyanidin extract to prevent selenite-induced oxidative stress in experimental cataract

PURPOSE: To investigate whether dietary supplementation with IH636 grape seed proanthocyanidin extract (GSPE) prevents selenite‐induced cataract. SETTING: Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey. METHODS: Thirty Spraque‐Dawley rat litters were put randomly into 3 groups. In group 1 (n = 10), sodium selenite (30 nmol/g body weight) was injected subcutaneously on postpartum day 10. In group 2 (n = 10), sodium selenite (30 nmol/g body weight) was injected on postpartum day 10 and oral GSPE (100 mg/kg body weight) was given for 1 week after sodium selenite injection. Only subcutaneous saline was injected in group 3 (control, n = 10). The development of cataract was assessed for 3 weeks, and its density was graded and photographed with a slitlamp. Removed rat lenses were analyzed for glutathione (GSH) and malondialdehyde (MDA). RESULTS: All of the rats in group 1 had cataract between stage 6 and stage 3. In group 2, only 5 of 10 eyes had cataract between stage 3 and stage 2 and no cataract occurred in the remaining 5 rats. The difference between mean cataract stages in group 1 and group 2 was significant (P<.05). The mean GSH level in group 1 was significantly lower than in group 2 and controls (P<.05). The mean MDA level in group 1 was significantly higher than in group 2 and controls (P<.05). CONCLUSIONS: IH636 grape seed proanthocyanidin extract effectively suppressed cataract formation in rats. Routine consumption of grape seed proanthocyanidin extract in the form of food or dietary supplement may offer a prophylactic measure against onset and progression of cataract.

Combined retinal artery and vein occlusion in a patient with systemic lupus erythematosus and antiphospholipid syndrome.

Systemic lupus erythematosus (SLE) is an autoimmune disease that primarily affects women, particularly those of childbearing age. Consequently, pregnancy and its outcome are of particular importance in this condition. Despite recent advances in the treatment of obstetric complications in women with SLE, the disease remains associated with significant fetal and maternal morbidity. 1 Retinopathy is one of the most important manifestations of SLE, with a reported incidence of 7% 2 to 26%. 3 Histologic evidence of immune-mediated vasculitis has also been reported in lupus retinopathy. 4

Acute effects of cigarette smoking on multifocal electroretinogram.

Background:  Cigarette smoking was shown to have stimulant effects on pattern visual‐evoked potentials. The aim of this study was to investigate the acute effects of cigarette smoking on multifocal electroretinogram (mfERG).

The acute effect of cigarette smoking on pattern visual evoked potentials

Reports of tobacco-induced electrocortical activation and decrements in ocular blood flow in the acute faze indicated that this effect is mediated via nicotin’s action or neuronal systems. In this study, pattern visual evoked potentials were investigated in a group of male smokers (22 right eyes of 22 subjects) in separate real smoking and sham smoking sessions. On each session, pattern visual evoked potentials were recorded before smoking, immediately after smoking, and five minutes after smoking. Latency and amplitude values for P100 peaks were assessed and analyzed in each smoking condition for both real smoking and sham smoking sessions. Real smoking significantly decreased P100 latency values (p value related to difference between pre-smoking and immediately after smoking conditions is 0.009) and increased P100 amplitude values (p value related to difference between pre-smoking and fifth minute after smoking is 0.039). Statistically no significant difference was observed in sham smoking sessions. Our results are consistent with smoking-induced stimulant effects on pattern visual evoked potentials.

Aicardi Syndrome: An Unusual Case Associated With Pineal Gland Cyst and Ventricular Septal Defect

Aicardi syndrome is a cerebroretinal disorder consisting of a heterogeneous spectrum of clinical findings that includes the triad of infantile spasms, agenesis of the corpus callosum, and chorioretinal lacunae. This report describes a 6-month-old girl who has all of the essential features suggestive of Aicardi syndrome, as well as a pineal gland cyst and ventricular septal defect. Although the characteristic features of Aicardi syndrome have been described, its association with pineal gland cyst and ventricular septal defect has not been reported in the literature.